By Dr. Anthony Policastro A number of professional football players have been suspended recently from several games because they tested positive for Adderall, a medication that is used to treat ADHD. Adderall is a stimulant. In children with ADHD, it is used to stimulate the area of their brain that blocks outside distractions. In adults it works like a true stimulant. Football players can use it for a number of different reasons. It might keep them awake at night to study their playbook or it might help them focus better during a game. The National Football League is correct in considering it a performance enhancing substance. However, as with any controversial topic, other aspects are not so clear cut. For example, there are currently 53 players on each NFL team. The incidence of ADHD in the general population is 5-7%. That means that there would be on the average 3 players per team with ADHD. It leads to the question as to whether something like Adderall is inappropriate for that group of individuals. Related to that is the fact that football is a very demanding physical sport. Individuals with ADHD have a lot of stamina. They might be more likely to be football players. That means it is possible that the incidence of ADHD in football players is higher than the 5-7% seen in the general population. A related issue is that even in individuals with ADHD, Adderall might not help their performance. One of the things that I explain to parents is that it varies with the individual and the sport. An individual with ADHD in the outfield in baseball is liable to be distracted between pitches. Thus, when the ball is hit, he/she might not be ready. Treating the ADHD would help this individual. Another individual might be someone who is fidgety and high motor in nature. In a football game, an individual like this is likely to be all over the field. This is a good thing. Treating the ADHD will likely make this individual less effective. Thus, there is no guarantee that the use of a medication like Adderall will actually help with performance. One of the effects of Adderall is appetite suppression. It was used as a diet pill in its early days. Football players need to maintain their calorie intake for peak performance. If they are not hungry because of Adderall, they may not eat which will diminish their performance. It is similar to the lean wrestler who decides to lose weight for a bout. Any weight loss will likely be muscle loss since the wrestler is lean to win the first place. That will make him weaker for the bout. Another issue is what happens with the football player who has been formally diagnosed with ADHD. That individual might have taken Adderall throughout school until college graduation. It would have been taken under a physician's supervision. Current rules do not allow that player to continue medication that he has taken for years. It is viewed as a performance enhancing substance but it might just be needed medication. There are football players who lose their temper on the football field which results in a penalty if they do not control it. It is possible that they have ADHD. It is also possible that they could control their impulsive behavior better with medication like Adderall. Adderall is a banned performance enhancing substance. The implication is that its use is always bad. However, like anything else, there are multiple sides to the story.

The stress of being a caregiverBy Visiting Angels Visiting Angels regularly offers what we hope are helpful tips for caring for elderly and disabled adults. Readers have shared their own stories with us, and our Visiting Angels home care agency has provided many families with excellent solutions and compassionate caregivers. Recently our career and private lives intersected when our own mother spent a week in the hospital, because of Alzheimer's, and she's not even the one who's suffering from it. A little background: Mom and her husband of 20 years live in Port St. Lucie, Fla., and are among the many unfortunate people who lost their entire savings through fraudulently run funds controlled by Bernie Madoff. With nearly nothing left in their retirement fund, and well past their earning years, they're forced to sell their home and everything they worked their whole lives for and decide where they might try to live off a small Social Security check. Dad, a proud, self-made, successful businessman, watched all he had disappear, quite literally overnight, but somehow mercifully seems to have accepted the situation. Mom, too, somehow found the strength to emerge strong with a positive attitudefor a while. When Dad began to exhibit forgetfulness, his doctors suggested he might be showing signs of early stage Alzheimer's. This was the proverbial final straw. Mom, who had endured losing everything with no retirement Plan B, began to experience serious panic attacks, culminating in a suicidal depression that took a week of rest in a facility to address. It's very often the caregiver, not the care recipient, who initially needs more help. The day she checked in, I immediately flew down to see her. I had been on many home visits, witnessing firsthand the stress felt by family caregivers, many who have little or no relief from 24-hour care. Providing solutions as a career is more rewarding than can be described, but here alone with my mom, I experienced fear and grief on a more personal level. The destructive effects of many diseases begin earlier than physical symptoms and can affect the entire family of the sufferer. Fortunately, I was able to share with her several important tips to cope with this time in her life. Many readers will have already experienced these various stages, and have implemented some of these strategies. The very first thing you need to do is give yourself permission to have help. Even before seeking resources, family and friends, you must admit to yourself that you're going to need help. There's plenty of help out there. Your experience feels extremely personal, but it is not unique. Take one day at a time and you can handle anything. Allowing yourself to experience fear for several weeks, months or years ahead of what hasn't yet happened is not fair to yourself or those around you. Focus on what you still have, and enjoy it. Our fear fantasies never match our future reality. Meeting with support groups is a must. You feel you have no time; you're exhausted and the last thing you need is to meet new people. Respectfully, this is wrong. The first thing you need is to meet people who are on the same road you're on but have traveled a bit further. This is where your fears are addressed and your questions answered, you find shoulders to lean on, and you are assured that there will always be others to share your worries. You can find a list of Sussex County support groups at the Resource page at visitingangels.com/sussexde. Wherever you are in your journey, we have experienced, compassionate caregivers that can help. We will care for you and your family the same way we care for ours. Visiting Angels can help with personal hygiene, dressing, meal preparation, walking, transfers and exercise, errands, shopping and appointments, laundry, light housekeeping, and compassionate companionship.

Ehrmann named patient advocate Bayhealth Milford Memorial recently promoted George Ehrmann of Milford to the role of patient advocate. Ehrmann is Bayhealth's first certified patient advocate. Patient advocates help families and patients navigate the complex health care system so that they receive the best care possible. In 2010, he successfully completed the Alfus Patient Advocacy Certificate Program through the University of Miami's Division of Continuing & International Education. A Bayhealth employee for nearly nine years, Ehrmann was previously the guest services agent at Milford Memorial, where he was often the first person to greet and assist patients, visitors, employee and physicians when they entered the hospital's main lobby. In his new role, Ehrmann has more direct contact with families and hospitalized patients.

DPH seeks input on health needs The Delaware Division of Public Health (DPH) wants your input on the major health needs in Delaware. DPH recently worked with a broad spectrum of non-profit and medical provider partners to create a draft statewide health assessment (SHA). The SHA is a careful examination of the health of our population which then is used to identify key problems and assets in Delaware. After receiving input, DPH will organize partners again to develop strategies and goals to address Delaware's major health needs. Four documents comprise the SHA. They include Community Themes and Strengths Assessment, Community Health Status Assessment, Forces of Change Assessment and Goals and Strategies. Input will be accepted through Jan. 31, 2013. Comments can be provided by health providers and agencies as well as the public. Visit www.dhss.delaware.gov/dhss/dph/files/shaform.pdf to open a form on which you can record and send your comments. For more information, call 302-744-4703.

NMH offers CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child, or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. Cost is $40. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Flu shots still available Flu shots are still available for the community by appointment. Influenza is a serious disease that affects many people, including the elderly and those with serious, long-term health problems. The U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone get a seasonal flu vaccine every year. Nanticoke Memorial Hospital is offering seasonal flu shots to individuals age 18 and older at Nanticoke Memorial Hospital's main campus (801 Middleford Rd., Seaford). There is no charge but a donation of $10 per vaccination is requested. Flu shots are available by appointment by calling 629-6611, ext. 2642.

Bayhealth welcomes surgeon Bayhealth announces the arrival of Orthopaedic Surgeon Michael L. Mattern, MD, and Orthopaedic Surgery Physician Assistant Allison L. Karish, PA-C, ATC. Dr. Mattern is a board-certified orthopaedic surgeon who has practiced medicine in Dover since 1981. He has served as the chief of Orthopaedic Surgery at Bayhealth, and is the team doctor for Dover High School and Wesley College. Prior to entering private practice, he served in the US Army Medical Corps. Karish received her master of science in sports medicine from the University of Pittsburgh and her master's of physician assistant studies from Seton Hall University. She has performed as an orthopaedic physician assistant in the office of Michael Mattern, MD, since June 2010. Prior to becoming a physician assistant, Karish received a bachelor of science in athletic training and was employed for several years as a certified athletic trainer. The Bayhealth Orthopaedic Surgery office of Dr. Mattern and Ms. Karish, PA-C, ATC, is located at 724 S. Governors Ave, Dover. To contact the office, call 302-734-3416.

Bariatric surgery info sessions When diet and exercise aren't enough to help you lose weight and keep it off, support and tools are available to help you meet your goals. Bariatric (weight loss) surgery can be the key to helping you get rid of many obesity-related health problems, such as diabetes, high blood pressure, depression and joint pain. The first step in the process is attending an informational seminar. The Bayhealth Bariatric Program conducts monthly bariatric surgery seminars for people interested in weight loss surgery. The next sessions will be held at 6 p.m. on Wednesday, Jan. 2, 2013 and Wednesday, Jan. 23 at Milford Memorial Hospital Conference Rooms A & B and Wednesday, Jan. 30 at Kent General Hospital General Foods Conference Rooms 1 & 2. Learn more about the Bayhealth Bariatric Program including the laparoscopic adjustable gastric banding surgery (LAP-BAND¨), The Laparoscopic Roux en Y Gastric Bypass, and the Laparoscopic Sleeve Gastrectomy. Find out about the risks, benefits and outcomes. Meet the surgeons, and staff of the bariatric program and ask them any questions and see if you meet the criteria for bariatric surgery. These seminars are free of charge and all are welcome. Register by calling the Bayhealth Bariatric Office at 430-5454 or register online at www.bayhealth.org.

Go Red for Women 2013 The Southern Delaware Go Red For Women will be held on Friday, Feb. 8, 2013. Tickets, which are $35 each, include extensive health screenings, $10 gift card from Macy's, guest gift bag and lunch, entertainment that includes fashion show and silent auction. Table sponsorships are $1,000 and exhibitor sponsorships are $1,500. The event begins at 10 a.m. with lunch and the program starting at noon. For more information, visit www.heart.org/southerndegoredluncheon.